Biomedical Engineering Program, Electrical and Computer Engineering Department, University of Connecticut, 371 Fairfield Rd, U2157, Storrs, CT 06269, USA.
Radiology. 2013 Feb;266(2):433-42. doi: 10.1148/radiol.12112415. Epub 2012 Dec 21.
To assess initial breast tumor hemoglobin (Hb) content before the initiation of neoadjuvant chemotherapy, monitor the Hb changes at the end of each treatment cycle, and correlate these findings with tumor pathologic response.
The HIPAA-compliant study protocol was approved by the institutional review boards of both institutions. Written informed consent was obtained from all patients. Patients who were eligible for neoadjuvant chemotherapy were recruited between December 2007 and May 2011, and their tumor Hb content was assessed by using a near-infrared imager coupled with an ultrasonography (US) system. Thirty-two women (mean age, 48 years; range, 32-82 years) were imaged before treatment, at the end of every treatment cycle, and before definitive surgery. The patients were graded in terms of their final pathologic response on the basis of the Miller-Payne system as nonresponders and partial responders (grades 1-3) and near-complete and complete responders (grades 4 and 5). Tumor vascularity was assessed from total Hb (tHb), oxygenated Hb (oxyHb), and deoxygenated Hb (deoxyHb) concentrations. Tumor vascularity changes during treatment were assessed from percentage tHb normalized to the pretreatment level. A two-sample two-sided t test was used to calculate the P value and to evaluate statistical significance between groups. Bonferroni-Holm correction was applied to obtain the corrected P value for multiple comparisons.
There were 20 Miller-Payne grade 1-3 tumors and 14 grade 4 or 5 tumors. Mean maximum pretreatment tHb, oxyHb, and deoxyHb levels were significantly higher in grade 4 and 5 tumors than in grade 1-3 tumors (P = .005, P = .008, and P = .017, respectively). The mean percentage tHb changes were significantly higher in grade 4 or 5 tumors than in grade 1-3 tumors at the end of treatment cycles 1-3 (P = .009 and corrected P = .009, P = .002 and corrected P = .004, and P < .001 and corrected P < .001, respectively).
These findings indicate that initial tumor Hb content is a strong predictor of final pathologic response. Additionally, the tHb changes during early treatment cycles can further predict final pathologic response.
在新辅助化疗开始前评估初始乳腺肿瘤血红蛋白（Hb）含量，监测每个治疗周期结束时 Hb 的变化，并将这些发现与肿瘤病理反应相关联。
本 HIPAA 合规研究方案经两个机构的机构审查委员会批准。所有患者均获得书面知情同意。符合新辅助化疗条件的患者于 2007 年 12 月至 2011 年 5 月间被招募，并使用近红外成像仪与超声（US）系统相结合来评估其肿瘤 Hb 含量。32 名女性（平均年龄 48 岁；范围，32-82 岁）在治疗前、每个治疗周期结束时和确定性手术前进行成像。根据 Miller-Payne 系统，根据最终病理反应对患者进行分级，分为无反应者和部分反应者（1-3 级）和接近完全和完全反应者（4 级和 5 级）。从总 Hb（tHb）、氧合 Hb（oxyHb）和去氧 Hb（deoxyHb）浓度评估肿瘤血管生成。从预处理水平归一化的 tHb 百分比评估治疗期间的肿瘤血管生成变化。使用两样本双侧 t 检验计算 P 值并评估组间的统计学意义。Bonferroni-Holm 校正用于获得多重比较的校正 P 值。
有 20 个 Miller-Payne 分级 1-3 肿瘤和 14 个分级 4 或 5 肿瘤。最大预处理 tHb、oxyHb 和 deoxyHb 水平在分级 4 和 5 肿瘤中明显高于分级 1-3 肿瘤（P =.005、P =.008 和 P =.017）。在治疗周期 1-3 结束时，分级 4 或 5 肿瘤的 tHb 百分比变化明显高于分级 1-3 肿瘤（P =.009 和校正 P =.009、P =.002 和校正 P =.004 和 P <.001 和校正 P <.001）。
这些发现表明，初始肿瘤 Hb 含量是最终病理反应的强预测因子。此外，早期治疗周期中的 tHb 变化可以进一步预测最终病理反应。
